Top medicine articles for April-May 2013

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Here are my suggestions for some of the top articles in medicine for April-May 2013:

Antibiotics for COPD exacerbations: Further Evidence of Benefit http://buff.ly/WOANHG

Diet does not work: substituting dietary linoleic acid in place of saturated fats increased the rates of death - BMJ http://buff.ly/WOAZH5

The Physician in US Cigarette Advertisements, 1930–1953 (illustrated review) http://1.usa.gov/VcuA7W via @Skepticscalpel

Nearsighted kids may get worse in winter http://trib.in/VcvmC1 -- Myopia progression seem to decrease in periods with longer days and to increase in periods with shorter days. Children should be encouraged to spend more time outside during daytime to prevent myopia (study) http://buff.ly/X1cFSm

The average physician spends nearly 11% of his or her career with an unresolved medical liability claim http://buff.ly/WZQZWJ

When Diet Meets Delicious - The Mediterranean Approach http://buff.ly/XCsvTJ -- Mediterranean diet prohibits nothing that was recognized as food by your great-grandmother.

Designing Tomorrow's Vaccines - NEJM free full text http://buff.ly/XCybNK

FDA Approves New Class of Type 2 Diabetes Drug: Invokana (canaglifozin) tablet http://buff.ly/16cNuNR

Incidence of coccidioidomycosis ("valley fever") increased 8-fold in the endemic area of U.S. between 1998-2011 http://buff.ly/YpvSyp

Erectile Dysfunction Severity as a Risk Marker for Cardiovascular Disease Hospitalisation and All-Cause Mortality http://bit.ly/16djmSx

More than 80% of prescriptions in the USA are now for generic (not brand name) drugs http://bit.ly/16djvWd

Smoke alarm - mental illness and tobacco - of 10 UK million smokers, up to 3 mln have a mental health disorder http://bit.ly/16djIZx

1 in 3 Americans has dementia at time of death http://buff.ly/11aMpXB

Studies conducted in high-income countries suggest that 2%–14% of scientists may have fabricated or falsified data http://buff.ly/YHHOYG

Discontinuation of Statins: most patients who are rechallenged can tolerate statins long-term http://buff.ly/16uEbe5

"Big Data" for Global Infectious Disease Surveillance - Free dynamic risk maps http://buff.ly/11j8Hq9

The articles were selected from my Twitter and RSS streams. Please feel free to send suggestions for articles to clinicalcases AT gmail.com and you will receive acknowledgement in the next edition of this publication.

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Every single hour of television watched after the age of 25 reduces the viewer’s life expectancy by 22 minutes

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By comparison, smoking a single cigarette reduces life expectancy by about 11 minutes.

An adult who spends an average of six hours a day watching TV over the course of a lifetime can expect to live 4.8 years fewer than a person who does not watch TV.

References:

Get Up. Get Out. Don't Sit. - NYTimes, 2012 http://nyti.ms/10oXBQd

Comments from Twitter and Google Plus:

Humera Naqvi, MD @nayab78: hmmm that means we ppl should be dying early taking the amount of tv watched but life expectancy has increased.

K Dillon, RDMS,CPC-A @comalliwrites: Confounders & confirmation bias not accounted for...

@ShadolooDoll: Misleading. It isn't TV itself, but the lack of activity. A person who is dedicated to exercise can still watch TV, right?

Timothy Cook: Great, since I stopped watching TV.  I can start smoking again!  ;-)?

Davíð Þórisson: Phew - no mention of watching Youtube! :-)?

Jimena Yosara Aguilar Jimenez: I'll never watch tv again?

Dimiter Stanev: Does that mean that disabled people suffer from this too??

Image source: Wikipedia, Creative Commons Attribution ShareAlike 2.5 License.

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"Attention span halved in a decade, from 12 to 5 minutes, spelling trouble for doctors and patients"

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From the WSJ:

Our average attention span halved in a decade, from 12 to five minutes. To combat this, a "museum intervention" is now mandatory at Yale's School of Medicine for all first-year medical students. Called Enhancing Observational Skills, the program asks students to look at and then describe paintings—not Pollocks and Picassos but Victorian pieces, with whole people in them. The aim? To improve diagnostic knack.


The Waterseller of Seville, 1618-1622, Oil on canvas. This is not considered an example of the "Victorian pieces" mentioned in the WSJ article. Image source: Wikipedia, public domain.

Each student is assigned a painting which they examine for 15 minutes, recording all they see. Then the group discusses its observations.

"We are trying to slow down the students. They have an urge to come up with a diagnosis immediately and get the right answer."

The study did not provide a huge improvement in the diagnostic acumen though. After the completion of the study project, the medical students were 10% more effective at diagnosis. Nonetheless, the program has now expanded to more than 20 U.S. medical schools. The evidence behind this intervention is not very convincing.

References:

Reviving the Art of Observation | Marvels - WSJ, 2012 http://goo.gl/iOhAV

Comments from Google Plus and Twitter:

Dr John Weiner @AllergyNet: Soon to become 140 characters? MT @DrVes: "Attention span halved in a decade, from 12 to 5 minutes” goo.gl/fb/818DN

andrew murphy, md @PAallergy: @DrVes took to long for me to read that story : )

Mike Moore: Interesting. What's the reference for "Attention span halved in a decade, from 12 to 5 minutes"?

Ves Dimov, M.D.: The reference is the text: "Our average attention span halved in a decade, from 12 to five minutes, according to a study commissioned by Lloyds TSB Insurance. (And that was in 2008.)" I haven't checked the source beyond the referenced WSJ article in this case.?

Mike Moore: Sorry, that was a bit of a rhetorical question. This is the best I could find, it doesn't appear to be an actual published study... http://www.insurance.lloydstsb.com/personal/general/mediacentre/homehazards_pr.asp?

Mike Moore: Even better, here is an analysis of when the "data" was initially released in 2008. http://neuroskeptic.blogspot.com/2008/11/spooky-case-of-disappearing-crap.html [The link to David Moxon, the "researcher" who was commissioned by Lloyds to do the study is now dead, replaced with a generic landing page. I guess he doesn't do "Psychological Research" anymore.]?

CMDoran @TheFebrileMuse: Yes, phones may be a part of this? very distracting..

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What is HDL? Videos for patient education by Cleveland Clinic

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Watch and learn how high-density lipoprotein (HDL) cholesterol can protect the body from heart disease in this whiteboard session lead by Cleveland Clinic Cardiologist Michael Rocco, MD.

Here are more videos from the same series:

What is LDL? - YouTube http://bit.ly/18cuEay

What is a lipid profile? - YouTube http://bit.ly/18cuFLE

What is cholesterol? - YouTube http://bit.ly/18cuHmX

What are the types of cholesterol? - YouTube http://bit.ly/18cuKPA

Time to treat your cholesterol numbers - YouTube http://bit.ly/18cuLmD

Know your cholesterol numbers - YouTube http://bit.ly/18cuMa7

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Greater Rochester Neurology

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Our goal is to provide the highest quality of medical care available in a courteous, timely and sympathetic manner.

COMING FROM THE NORTH OR WEST Take 490 to 390 South

Exit 390 at 16B (E. Henrietta Rd.)

Turn left at the exit. Make a Right on Westfall Rd.

Pass South Clinton and make a Left at Lac De Ville Blvd.

Were on the left side of the road past homes opposite pond.

COMING FROM THE EAST Take 490 to 590 South and exit at Winton Rd.

Turn Right at exit. Then turn Left on Westfall Rd.

The second light is Lac De Ville Blvd. Turn Right at this light.

Were on the left side of the road past homes opposite pond.

COMING FROM THE SOUTH Take 390 North to 590 and exit at Winton Rd. Turn Left at exit and another Left at Westfall Rd.

The second light is Lac De Ville Blvd. Turn Right at this light.

Were on the left side of the road past homes opposite pond.

Appointment Hours: Monday - Friday 7:00am - 4:00pm

Telephone Hours: Monday - Friday8:30am - 12:00pm 1:30pm - 4:00pm

Go here to see the original:
Greater Rochester Neurology

"The happiest people in the world" live in Denmark and the happiness is lowest in middle age

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According to the "World Happiness Report", the happiest people in the world live in Denmark, Finland and Norway. The report is published by the United Nations (the first edition was in 2012).

According to one of the people interviewed, it's all an expectations game: "We don't expect much from life in Denmark, and we are happily surprised when something goods happens." (quote from memory). I doubt that it is that simple. Here is the Deutsche Welle video:

The top 10 happiest nations on the planet are:

1. Denmark
2. Finland
3. Norway
4. Netherlands
5. Canada
6. Switzerland
7. Sweden
8. New Zealand
9. Australia
10. Ireland

Happier countries tend to be richer countries. Over time as living standards have risen, happiness has increased in some countries, but not in others (like for example, the United States). On average, the world has become a little happier in the last 30 years (by 0.14 times the standard deviation of happiness around the world).

Stable family life and enduring marriages are important for the happiness of parents and children. In advanced countries, women are happier than men, while the position in poorer countries is mixed.

Happiness is lowest in middle age.

References:

First World Happiness Report Launched at the United Nations - The Earth Institute - Columbia University http://bit.ly/ZdgyAr

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